Application Name* First Last Date of Birth* Mobile Number*Email Address* Relationship Status*Ages of living Children (if applicable)Postal Address* Street Address Suburb / City State / Province / Region ZIP / Postal Code Please let me know why you are interested in MotherQuest, what drew you to this work and what are your hopes / wishes for attending:*Please share any experiences you have had with counseling, psychotherapy, or other personal or growth work:*Do you personally have any history of physical/sexual/domestic violence abuse or alcoholism/addiction, psychosis? To your knowledge, did any of your fore-mothers?*Please describe your mother/daughter relationship. Is it how you would like it to be? If you have your own daughters - are these relationships how you would like them to be? How about your sons (if you have them)?*Have you suffered from abuse, trauma or surgery to your reproductive area (including if you feel to share rape, traumatic births or abortions)? (This is asked so that I can make our work together safe for you).*Are you a mother to children who are no longer living? (Including miscarriages, babies & children who died).*If you birthed children, how would you describe your experience/s?*Where is your mothering energy mostly focused? (i.e. children /work /a current project /pet etc)*How is your soul life nourished and supported within your (intimate / marriage) relationship? Is your partnership where you wish it could be? If not what needs to change?*What do you currently most fear? How do you process your fears/work through them?*How do you deepen your relationship with yourself? How well do you like yourself on the inside as well as who you are to others?*If your Shadow is where you least know or love yourself - what parts of your shadow are you most ready to work on?*Please describe your spiritual journey and current spiritual practice or share what currently feeds your soul.*What is your experience of women’s groups and ‘circles’? What could be reasons for you not feeling safe with other women?*What do you most wish for in your world / life? Who do you wish to be and how do you wish to be different /more of after this 13 month MotherQuest?*Is there anything that you want me to know, so I can support you best during your participation in this program?*How did you hear about MotherQuest?*Which program are you enrolling in?* MotherQuest : Journey Woman Training | In person Gold Coast MotherQuest : Journey Woman Training | Online Would you like to join our mailing list? Yes. Please sign me up.
